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Clowns, cancer and psychoneuroimmunology

Posted Feb 27 2010 10:07am
Speaking of clowns. During the last day or so of my treatment last week, when things started getting a little blurry and the walls began offering visions of baby snow monkeys, I faced a predicament. The doctor wanted to thin my blood, and the way they go about doing that is to stick you in the belly with a needle. I don't really know the rest, as once I heard this I recoiled and suggested that the doctor stick the needle in her own eye if she were thinking about approaching my torso with anything pointy.

So we made a deal. She said that if I would walk at least one lap around the hospital ward, then I could avoid the Needle. As I am a reasonable man, and will do anything to avoid the evisceration of my intestines, I shook hands on the deal.

And so I began a daily lap, a demented track athlete swinging my IV cart alongside me as I passed others, usually elderly men wearing gowns and black socks.

On the last day or so I recall making the lap with a kind of drunken precision, meticiously following my line of sight down the corridor, yet helpless banging my IV cart into various pieces of equipment that lined the hall. Dena walked alongside me, trying to steer me while I insisted I knew what the hell I was doing and where I was going in the way of all inebriates.

And then -- bang! I walked clean into a carrot topped big shoed bulboused nosed honest to god clown. Right there in the middle of one of the hospital's more critical wards.

As the kids say: WTF? Seriously, a clown?

I worried that if I had seen snow monkeys and japanese goth chicks in my room that I was seeing more of the same here in the hall. Surely there is some kind of regulation banning clowns from cancer wards?

Evidently not. The clown was real. I know this because the creature creeped out my wife, who is notorius for her fear and loathing of all things clown.

So we made small talk, the clown and I.

What brings you to this part of the hospital?
Cancer, you?
Oh, clown stuff.

We went on like this for a while, talking the talk of clowns and cancer, until she offered me a sticker. (The clown, while androgynous for the most part, evidenced feminine qualities.) She pinned it on my chest, as if I had just voted.

The she followed me.

Clowning is a subtle business. There is a fine line between humor and psychosis. Stalking tends to cross that line.

In my room she offered me a paddle ball while Dena eyed her with a good deal of open wariness. Paddle ball is a good way to relieve stress, she pointed out. And I suppose that is true if you are any good at it. I am not, and my heart rate, already in the red, began to spike as I pumped this silly wooden plate against a ball attahced to a rubber string, missing and missing and cursing the clown who had followed me into my room to humiliate me.

Perhaps embarrased by my lack of coordination, the clown eventually left. Later I would learn that clowns and stickers and funny movies are part of the Duke Cancer Center's program, meant to encourage the ill, and pump their immune systems with positive emotions. There is an entire medical research category -- psychoneuroimmunology -- dedicated to the study of how emotions and mental outlook can affect the immune system in both positive and negative ways, stimulating the immune system's "natural killer cells" to fight cancer, like caped white blood cells come to save the day, or suppress those same cancer-fighting cells. Duke is actually one of the leaders in this field of research and medicine, and the clown is one result of such research. I think there may be something to this concept, but I might replace the clown with with something less intimidating. A Japanese goth chick, perhaps.
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